Your Thyroid and Your Heart. Dr. Jacob Teitelbaum

Your Thyroid and Your Heart

The obvious symptoms of hypothyroidism— such as fatigue, depression, and overweight— are bad enough. But hypothyroidism can cause more than everyday suffering. It can end your life.

Women with untreated hypothyroidism are more than twice as likely to suffer a heart attack, reported a team of Norwegian researchers in a recent issue of the Archives of Internal Medicine. In their 8-year study of more than 25,000 people, they found that women with somewhat low thyroid levels (considered normal by most doctors) had a 69 percent higher risk of dying from heart disease. “These results indicate that relatively low but clinically normal thyroid function may increase the risk of fatal coronary heart disease,” they wrote. A 69 percent higher risk means that hypothyroidism could cause more heart attacks in women than smoking, elevated cholesterol, high blood pressure, or diabetes. Another way to look at it: Detecting and treating those cases of hypothyroidism could save 30,000 lives a year— one of which may be yours!

Unreliable thyroid tests

Most doctors don’t know about research showing that the TSH (thyroid-stimulating hormone) test— the test typically used to check your thyroid— is very unreliable, failing to spot most of the people who need to take extra thyroid hormone. And the test for “free T4”— one form of stored thyroid— is considered “abnormal” only if you have outright thyroid failure!

Why do standard tests fail to identify such a common problem? Well, most labs establish a “normal” range for test results using a statistical formula called “2 standard deviations”: Out of every 100 people tested, those with the two highest and the two lowest scores are abnormal, and everybody else is normal. Imagine applying the same medical standard to determine a “healthy” shoe size. Any size between 4 and 13 would be “normal”— and if a man was fitted with a too-small size 5 shoe or a woman with a too-large size 12, the doctor would say the shoes were perfectly okay! That approach is wrong.

Human beings aren’t statistics; they’re individuals. Thyroid tests within the so-called normal range may be abnormal for you, producing symptoms that are never solved because conventional medicine can’t find their cause. Here’s another problem with thyroid tests. Over the decades, they have been continually updated, with ever-expanding definitions of who is and isn’t hypothyroid.

There’s no reason to believe that the current test effectively detects every case of hypothyroidism, because none of the previous tests did. Some history about this situation: When I was in medical school, doctors diagnosed hypothyroidism by measuring the metabolic rate during a treadmill test. A decade or so later, a new, more accurate test used protein-bound iodide (PBI) as a measure of thyroid function. After that, there was the T4-level thyroid test, outdating the PBI test and detecting even more cases of hypothyroidism. That test was followed by the new and improved T7 test. And then the T7 test was replaced by the TSH test, the current favorite.

Are we accurate yet? No. In 2002 the American Association of Clinical Endocrinologists (AACE) revised the normal range for the TSH test (0.5 to 5.0), stating that anyone with a TSH over 3.0 was hypothyroid— that means approximately 13 million Americans with ranges from 3.1 to 5.0 had not been treated for hypothyroidism because their lab results had been regarded as normal.

Yesterday, we told you that you were well; today, we’re telling you that you are ill. Sorry about that! Here’s what the press release stated: “Until November 2002, doctors had relied on a normal TSH level ranging from 0.5 to 5.0 to diagnose and treat patients with a thyroid disorder who tested outside the boundaries of that range. Now, AACE encourages doctors to consider treatment for patients who test outside the boundaries of a narrow margin based on a target TSH level of 0.3 to 3.0. AACE believes the new range will result in proper diagnosis for millions of Americans who suffer from a mild thyroid disorder, but have gone untreated until now. “‘ The prevalence of undiagnosed thyroid disease in the United States is shockingly high— particularly since it is a condition that is easy to diagnose and treat,’ said Hossein Gharib, MD, FACE, and president of AACE. ‘The new TSH range from the AACE guidelines gives physicians the information they need to diagnose mild thyroid disease before it can lead to more serious effects on a person’s health— such as elevated cholesterol, heart disease, osteoporosis, infertility, and depression.’” Bravo for the AACE. But apparently that press release wasn’t read by a lot of medical professionals. Most labs (and doctors) still use the old criteria, considering TSH up to 5.5 to be normal— resulting in 13 million American women having their low thyroid levels missed by standard testing. And that isn’t the only way hypothyroidism is missed. Rather, it’s just the tip of the iceberg! Your thyroid also could be underactive because of an underactive hypothalamus, so you can suffer the hypothyroidism and have a normal TSH. Case in point: Dr. G. R. Skinner, of the United and his colleagues tested thyroid hormone levels of 80 “clinically hypothyroid patients” (people with symptoms of hypothyroidism) and found their TSH was “well within” the normal range. When Dr. Skinner treated those patients with 100 to 120 micrograms a day of thyroid hormone (Synthroid), the large majority of them improved. Ignoring thyroid-caused symptoms in people with “normal” lab results can “condemn many patients to years of hypothyroidism with its pathological complications and poor quality of life,” said Dr. Skinner and his colleagues in the British Medical Journal.

Yet another study shows that only 3 percent of those tested for low thyroid have tests that confirm their hypothyroidism. In other words, the doctor suspected it, tested for it, but didn’t find it.

To me, there is an obvious conclusion: Current thyroid testing misses diagnosing most people who are hypothyroid, which I define as having significant health problems that improve when treated with thyroid hormone. I say: Treat the patient and not the test! If you have just one or two of the possible symptoms of hypothyroidism— unexplained fatigue, persistent depression, achy muscles and joints, miscarriages, infertility, heavy periods, constipation, easy weight gain, cold intolerance, dry skin, thin hair, and a body temperature that tends to be on the low side of normal— you deserve to be treated for hypothyroidism.